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$Title{Can Bone Marrow Transplants Cure Anemia?}
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Copyright (c) 1992,1993   Tribune Media Services, Inc.


Can Bone Marrow Transplants Cure Anemia?


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QUESTION:  I was told by my doctor that I am mildly anemic.  I started taking
vitamins with iron, but after several weeks I am still anemic.  I now read
that there is a type of bone marrow transplant that can be done.  Do you think
that I should ask to have this done on me to cure my anemia?  I would be very
grateful to you for your opinion.

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ANSWER:  Let me start with your anemia problem before I take this opportunity
to discuss bone marrow transplantation.  A mild anemia is not a serious
condition, and a few weeks of multivitamin and iron supplement may not be
sufficient time to see the problem resolved.  Give yourself a chance, and if
the hemoglobin does not rise to desired levels, let your doctor take a few
more tests to determine the cause of your particular anemia, and prescribe
some of the available remedies for the situation.
     While you are correct in relating bone marrow to blood production, anemia
is not one of the conditions for which bone marrow transplantation (BMT) is
indicated.  Bone marrow contains the special cells that form red blood cells
(the kind that carry the hemoglobin) as well as white blood cells (WBC) of
several types, and platelets (that play a major role in blood clotting).  WBCs
belong to the immune system, and provide the first line of defense against
infections.  Because the marrow produces so many cells, it is an area in which
there is active and rapid growth, and the metabolism of the cells is high.
     The main use of BMT is during the treatment of several types of cancer
and leukemia.  Both the chemicals used to fight the cancer and the radiation
therapy which may form part of the treatment can damage the highly active bone
marrow.  Therefore the doses of both may sometimes be kept down to protect the
sensitive marrow.  These low doses may not always be totally effective against
the cancer cells, whereas higher doses might do the complete job.  In such
cases BMT becomes an important tool.
     Bone marrow for transplantation can come from one of three sources.  It
may come from the patient (autologous).  It is removed (or harvested) before
treatment starts, and stored until it is needed.  Marrow from a twin is called
"syngeneic" while marrow from brothers or sisters, other members of the family
or unrelated donors is called "allogeneic".  The immunological makeup of the
bone marrow must closely resemble that of the patient, a task that is not
always easily accomplished.  However, once the availability of a suitable
supply is assured, the cancer treatment can be started.
     During the days of chemotherapy and radiation therapy, the cancer cells
are destroyed (hopefully), but the sensitive marrow cells may also be killed.
In addition, the loss of the living marrow removes the body's own protection
from infectious disease.  The patients must be placed in protective isolation
during this time and until the transplanted marrow has sufficient time to
produce the sufficient white cells to fight infection.
     The marrow is placed back into the body through intravenous catheters or
tubes.  Once in the bloodstream, these cells travel to the bone cavities where
marrow normally grows, and begin producing cells.  This begins about 14-30
days following the transplantation.  When the daily blood counts show that the
amount of circulating WBCs (neutrophils) have reached sufficiently high
levels, the patient may be discharged from the institution, for continuing
outpatient follow-up care.

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The material contained here is "FOR INFORMATION ONLY" and should not replace
the counsel and advice of your personal physician.  Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.